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Outpatient electrofulguration for antibiotic-recalcitrant recurrent urinary tract infections in women with trigonitis alone

Stevens J1, Chavez J1, Christie A2, Zimmern P1

1. Department of Urology, U.T. Southwestern Medical Center, 2. Simmons Comprehensive Cancer Center, U.T. Southwestern Medical Center

KEYWORDS: Female, Infection, Urinary Tract, Surgery

Urinary tract infections affect up to 50% of women each year. Some have recurrent urinary tract infections (RUTIs; 3 UTI/year) and require repeated and/or prophylactic antibiotic courses[1] which can lead to development of antibiotic resistance without UTI resolution. Prior cystoscopic studies have noted areas of chronic inflammation (trigonitis when limited to trigone) that can house bacterial persistence.[2] Electrofulguration (EF) is an outpatient endoscopic cauterizing technique which eliminates these superficial areas of inflammation to eradicate these bacterial niches.[3] A previous study of EF in management of RUTIs in women with a variety of cystitis lesions involving the trigone and beyond reported 75% resolution of inflammatory lesions and over 80% improvement in UTI rates.[3] Our hypothesis is that given the lesser burden of disease in women with limited trigonitis compared to those with advanced cystitis lesions, they should respond the best to EF. Therefore, the goal of this study was to evaluate the response to EF for trigonitis alone in women with antibiotic-recalcitrant RUTIs.